Breast Reduction and Mastopexy for Repair of Asymmetry After Breast Conservation Therapy: Lessons Learned

Barnea, Yoav; Bracha, Gal; Arad, Ehud; Gur, Eyal; Inbal, Amir

doi:10.1007/s00266-019-01338-0

Cited by 6 publications

(10 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9,10 The incidence of fat necrosis varies in the literature; while some studies report rates as high as 38%, others suggest it is less common, possibly do to underreporting. 5,6,[11][12][13][14] In our series, fat necrosis was reported in 36 breasts (10.74% of the cases), which might also reflect the lack of diagnosis and underreporting. We also found that in the cases of BBR surgery, cases of fat necrosis were always unilateral.…”

Section: Discussionmentioning

confidence: 67%

Treatment Algorithm of Postsurgical Fat Necrosis of the Breast—Revisited

et al. 2022

Self Cite

View full text Add to dashboard Cite

Fat necrosis is a common complication of breast surgery, with the potential to cause both functional and aesthetic repercussions that can affect patient satisfaction. Although several fat necrosis classification systems have been proposed, fat necrosis management varies widely across institutions, requiring revisiting of existing treatment protocols. We evaluated the postoperative outcomes on 335 breasts following either breast reduction or reconstruction with deep inferior epigastric perforator (DIEP) flaps at our institution between 2016 and 2020, with particular attention to the development of fat necrosis and the need for subsequent surgical intervention. Fat necrosis was diagnosed in 36 (10.74%) breasts, of which 16 (44.4%) were surgically removed and 20 (55.5%) were conservatively managed. Time of fat necrosis diagnosis: early (≤one-month after breast surgery) or late (>1 month) was the only variable associated with surgical intervention. Fat necrosis management should be approached on a case-by-case basis. Whenever possible, conservative management with regular clinical and radiological follow-up, and patient reassurance, should be pursued even for large masses, in the absence of concomitant complications.

show abstract

Section: Discussionmentioning

confidence: 67%

Treatment Algorithm of Postsurgical Fat Necrosis of the Breast—Revisited

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Other investigators have described mostly minor complications, occurring in 22% to 25% of patients, when investigating the safety of both reduction mammaplasty and mastopexy in the irradiated breast. 2,12,19 Significant asymmetry has been estimated to be present in 35% of patients who underwent CS + RT. 4,24 Furthermore, women with macromastia were found to have a higher risk of asymmetry, experienced prolonged edema, and a higher rate of fibrosis, resulting in inferior aesthetic outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Christiansen et al 5 reported no postoperative complications using the omega technique reduction mammaplasty. Other investigators have described mostly minor complications, occurring in 22% to 25% of patients, when investigating the safety of both reduction mammaplasty and mastopexy in the irradiated breast 2,12,19 …”

Section: Discussionmentioning

confidence: 99%

Safety of Reduction Mammaplasty and Mastopexy After Breast Conservation Therapy and Radiation Therapy

2023

View full text Add to dashboard Cite

Background Conservative surgery and radiotherapy (CS + RT) have become the standard of care for early-stage breast cancer as an alternative to mastectomy. With the increasing rate of obesity and incidence of macromastia, surgeons increasingly encounter patients with a history of breast radiation desiring breast reduction. However, elective breast surgery after irradiation remains to be controversial due to known adverse effects of radiation, especially on wound healing, and unknown effects of lumpectomy on traditional pedicle choices. Herein, we present our experiences and outcomes of reduction mammaplasties and mastopexies in patients with breast cancer previously treated with CS + RT. Methods Between 2009 and 2020, 13 patients undergoing reduction mammaplasty or mastopexy, who have previously underwent CS + RT with or without axillary surgery, were included in this study. Surgical techniques and complications, including delayed wound healing, infection, fat necrosis, and nipple-areolar necrosis, were recorded and analyzed based on the irradiated versus nonirradiated sides. Results Of the 13 patients, delayed wound healing occurred in 7% on the irradiated side and 15% on the nonirradiated sides (P > 0.05). No significant correlation was observed between the number of complications and time of elective breast surgery from the last radiation therapy. Complications between irradiated and nonirradiated breasts did not significantly differ in both the reduction mammaplasty and mastopexy groups. Conclusions Reduction mammaplasty and mastopexy in patients with a history of lumpectomy and breast irradiation can be safely performed and should be considered in those experiencing macromastia or asymmetry post-CS + RT.

show abstract

“…Irradiated tissues are associated with increased rates of surgical complication throughout the body [ 20 , 21 ]. This is especially true with radiated breast reconstruction, as evidenced by the higher rates of infection, capsular contracture, implant exposure, and overall reconstructive failure [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. Though still the most common form of reconstruction being performed today, staged expander-to-implant-based reconstruction is especially sensitive to the unintended side effects of radiation.…”

Section: Use Of Radiation In the Breast Cancer Patientmentioning

confidence: 99%

Lipotransfer Strategies and Techniques to Achieve Successful Breast Reconstruction in the Radiated Breast

Crawford

Endara

2020

Medicina

View full text Add to dashboard Cite

Radiation therapy is frequently a critical component of breast cancer care but carries with it side effects that are particularly damaging to reconstructive efforts. Autologous lipotransfer has the ability to improve radiated skin throughout the body due to the pluripotent stem cells and multiple growth factors transferred therein. The oncologic safety of lipotransfer to the breasts is demonstrated in the literature and is frequently considered an adjunctive procedure for improving the aesthetic outcomes of breast reconstruction. Using lipotransfer as an integral rather than adjunctive step in the reconstructive process for breast cancer patients requiring radiation results in improved complication rates equivalent to those of nonradiated breasts, expanding options in these otherwise complicated cases. Herein, we provide a detailed review of the cellular toxicity conferred by radiotherapy and describe at length our approach to autologous lipotransfer in radiated breasts.

show abstract

Breast Reduction and Mastopexy for Repair of Asymmetry After Breast Conservation Therapy: Lessons Learned

Cited by 6 publications

References 38 publications

Treatment Algorithm of Postsurgical Fat Necrosis of the Breast—Revisited

Treatment Algorithm of Postsurgical Fat Necrosis of the Breast—Revisited

Safety of Reduction Mammaplasty and Mastopexy After Breast Conservation Therapy and Radiation Therapy

Lipotransfer Strategies and Techniques to Achieve Successful Breast Reconstruction in the Radiated Breast

Contact Info

Product

Resources

About